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ELC-16-2592 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-267608 Permit Number: ELC-9-16-2592 Inspection Date: October 04, 2016 Permit Type: Electrical - Commercial Inspector: Devaney, Michael Inspection Type: Final Owner: , Work Classification: Addition/Alteration Job Address:9823 NE 4 Avenue Miami Shores, FL Phone Number Parcel Number 1132060170330 Project: <NONE> Contractor: MOODY ELECTRIC INC Phone: (305)758-2000 Building Department Comments REPLACE 100 AMP MAIN DISCONNECT FOR A/C Infractio Passed Comments EQUIPMENT INSPECTOR COMMENTS False Inspector Comments Passed 1Z Failed Correction Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. For Inspections please call: (305)762-4949 October 03,2016 Page 1 of 1 s ° y, Miami Shores Village Perm " 'lal 10050 N.E.2nd Avenue NE k � Ft� dCtMe�+Ot1 Miami Shores,FL 33138-0000 g � ,- '' � Phone: (305)795-2204 Ex tration: 03121/2017 Project Address Parcel Number Applicant 9823 NE 4 Avenue 1132060170330 Miami Shores, FL Block: Lot: MIAMI SHORES COMM CHURCF Owner Information Address Phone Cell MIAMI SHORES COMM CHURCH INC 9823 NE 4 AVE MIAMI FL 33138-2402 Contractor(s) Phone Cell Phone Valuation: $ 1,298.00 MOODY ELECTRIC INC (305)758-2000 Total Sq Feet: 0 Type of Work:REPLACE 100 AMP MAIN DISCONNECT FOR Available Inspections: Additional Info:REPLACE 100 AMP MAIN DISCONNECT FOR Inspection Type: Classification:Commercial Final Scanning:1 Meter Box Alteration Relocation Fire Alarm Service Change Review Electrical W.W. Underground Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $1.20 DBPR Fee InvOiCe# El-C-9-165-61404$2.25 09/20/2016 Credit Card $50.00 $115.70 DCA Fee $2.25 Education Surcharge $0.40 09/22/2016 Credit Card $ 115.70 $0.00 Notary Fee $5.00 Permit Fee $150.00 Scanning Fee $3.00 Technology Fee $1.60 Total: $165.70 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that th foregoing i rm ion is ccurate and tha ork will be done in compliance with all applicable laws regulating construction and zoning. Futhemtore,I orize the ab -n me o tractor to do the work s d. September 22,2016 Authorized Signature:Ow or / ApContractor / Agent Date Building Department Copy September 22,2016 1 Oi0 Miami Shores Villa e c�T D g s � o Zoos .l� Building Department . 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBc 20 i4 BUILDING Master Permit No.ELc 9 -t 6-Z59 2 PERMIT APPLICATION Sub Permit No. ❑BUILDING X ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP ��, 11 CONTRACTOR DRAWINGS JOB ADDRESS: C �2_� ME, L? ANk' City: Miami Shores County: Miami Dade Zip: 3?1�S --- Folio/Parcel#: 11 - 32-06 d 1-1-0 330 Is the Building Historically Designated:Yes c NO Occupancy Type: Load: Construction �Type: ` �j�F9llo�od�ZBon/e: �� BFE: �I FFE: , `c OWNER: Name(Fee Simple Titleholder): MIW� SOS tQM I1�ev�11 "o Phone#: � I59-39`U Address: !3E2_3 �JL qTff NFL i� City: ml��11 906 State: ELM M Zip: 3�I�3L Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: ®®� sL l �L 11�11�• Phone#: 3'�3SICJ7ti Address: �)a 12— K) 211'" WJE city Ll.gLK)Oct> State: �1,�'>�� Zip: Qualifier Name: ,®) . M®l_®�-) Phone#: J0S-1'5t`3 C)0 State Certification or Registration#: EL-.QC0 119 Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: �1 Cy City: State: Zip: Value of Work for this Permit:$ /_ 1�, oo Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition nn Description of Work:yF"JPLAA('f1 Inc PM? MIM) Specify color of color thru tile: Submittal Fee$ Permit Fee$ l✓d�� CCF$ �' CO/CC$ Scanning Fee$ 3• CC) Radon Fee$2. 2S DBPR$ 2 . 2� Notary Technology Fee$( G Training/Education Fee$ d ' 40 Double Fee$ 9) Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ I I •�� f RPvicPdn7/94/9n141 Bonding Company's Name(if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name(if applicable) Mortgage Lender's Address I LP City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRIC, PLUMBING, SIGNS, POOLS, FURNACES,BOILERS, HEATERS,TANKS,AIR CONDITIONERS,ETC..... OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also,a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature I' OWNER AGENT CONTRA OR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this (gyp day of � '7�(` �� .20 by 2 day of 5±12jf ffl bP�(' .20 1 i by (NA7;vho is personally known to 16hil J M who is personally known to me or who has produced TL bl2j VEr_ me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY P LIC: NOTARY PUBLIC: Sign: Sign: Print: Print: Seal: s,, otiFftY C=,,� Notwy i`'u)rc Sint=of Florida Rebece Munoz �F o 4incii.,A.h;ar�� Seal: AAyComm►aafa►FF9183�4 Al",om^ise,ic^FF�s6"Sp PExoes @9108wo �uFs°a Cxnifet0�±i.3%"?13 4� APPROVED BY , �� r'91"'®AI� Plans Examiner Zoning Structural Review Clerk I Rc.A-4n7/7 n/7n9 n 1 9/20/2016 Detail by Entity Name sf. . DIVISION OF CORPORATION'S Detail by Entity Name Florida Not For Profit Corporation MIAMI SHORES COMMUNITY CHURCH, INC. Filing Information Document Number N49539 FEUEIN Number 59-0657328 Date Filed 06/24/1992 State FL Status ACTIVE Principal Address 9823 NE 4TH AVE. MIAMI SHORES, FL 33138 Changed: 03/18/2009 Mailing Address 9823 NE 4TH AVE. MIAMI SHORES, FL 33138 Changed: 03/18/2009 Registered Agent Name &Address SASTRE, MICHAEL A 2 SOUTH BISCAYNE BLVD. SUITE 3050 MIAMI, FL 33131 Name Changed: 05/20/2009 Address Changed: 05/20/2009 Officer/Director Detail Name $Address Title President PATTAVINA, DIANE 758 NE 90 Street#515 MIAMI, FL 33138 Title VP httpJ/serch.simbiz.agnnory/CorpaadonSearch/SearchResUtDetail'ArgWrytyp EnUtyName&cirecticnType=lnitial&swrchNameOrder=MIAMISHORESC... 1/3 9202016 Detail by Entity Name LANGFORD, DRACE 720 NE 69 STREET #8 MIAMI, FL 33138 Title Treasurer SELL, MARK 15051 ROYAL OAK LANE #405 MIAMI SHORES, FL 33181 Title Secretary ISE, JOHN 118 NE 102 STREET MIAMI SHORES, FL 33138 Title MINISTER AND CAO WATSON, MARGARET, REV 386 NE 99 STREET MIAMI SHORES, FL 33138 Annual Reports Report Year Filed Date 2014 03/03/2014 2015 04/08/2015 2016 03/29/2016 Document Images 03/29/2016 --ANNUAL REPORT View image in PDF format 04/08/2015 --ANNUAL REPORT View image in PDF format 06/27/2014 --AMENDED ANNUAL REPORT View image in PDF format 03/03/2014 --ANNUAL REPORT View image in PDF format 03/19/2013 --ANNUAL REPORT View image in PDF format 03/20/2012 --ANNUAL REPORT View image in PDF format 05/11/2011 —ANNUAL REPORT View image in PDF format 03/02/2010 --ANNUAL REPORT View image in PDF format 05/20/2009 -- Reg. Agent Change View image in PDF format 03/18/2009 --ANNUAL REPORT View image in PDF format 03/14/2008 --ANNUAL REPORT View image in PDF format 04/02/2007 --ANNUAL REPORT View image in PDF format 07/05/2006 --ANNUAL REPORT View image in PDF format 04/14/2005 --ANNUAL REPORT View image in PDF format httpl/searchsurtiz.orgAngUry/CorprationSearchtSwchResultDetail'AingUryWpo-End"ame&cUrectionType=ir itial8searchNoneOrder=MIAMISHORESC... 2/3 9/20/2016 Detail by Erdity Name 02/27/2004 --ANNUAL REPORT View image in PDF format 05/05/2003 --ANNUAL REPORT View image in PDF format 05/21/2002 --ANNUAL REPORT View image in PDF format 04/23/2001 --ANNUAL REPORT View image in PDF format 04/19/2000 --ANNUAL REPORT View image in PDF format 03/29/1999 --ANNUAL REPORT View image in PDF format 04/15/1998 --ANNUAL REPORT View image in PDF format 02/28/1997 --ANNUAL REPORT View image in PDF format 03/29/1996 --ANNUAL REPORT View image in PDF format 06/14/1995 --ANNUAL REPORT View image in PDF format Cor)vright ©and Privacy Policies State of Florida,Department of State W/sewch.sunbiz.ag4ngUry/Corpo 4mSearch/SearchRosultDoWl'Arxltary"e=EnUtyNameWrwUc)nType=initial&serchNameOrder=MIAMISHORESC... 3l3 U) M a r ao r r r r CD a RICK SCOTT,GOVERNOR KEN LAWSON,SECRETARY 3 0 STATE OF FLORIDA 0 DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION cc ELECTRICAL CONTRACTORS LICENSING BOARD m ECOQ01199 .' m0 The ELECTRICAL CONTRACTOR `t Named below 13 CERTIFIED Under the provisions of Chapter 489 FS. :. , . :: ; =::: 0 Expiration date: AUG 31, 2018 , 3 0 MOODY,JOHN J ,. �. MOODY ELECTRIC, IN • 13700 ROANOKE ST : .. DAVIE 0 ISSUED: 07/27/2016 }DISPLAYAS REQUIRED BY LAW SEQ# 1.1607270001627 v U1 W W W • si a r